WHITE HOUSE:

With the end of year Holidays, and the final weeks of the Administration slowly coming to a close, it’s been very quiet out of the White House. They focused on blocking the sale of US Steel to a Japanese company, the horrific terror attack in New Orleans, and continuing to sign outstanding pieces of legislation. One item of interest:

• • On January 1^st, 2025, one of the key provisions of the Inflation Reduction Act went into effect. Under the law, there’s a new cap of $2,000 for Medicare Part D beneficiaries on out-of-pocket costs for prescription drugs. Here’s a good summary of the cap and how it works.

CONGRESS:

Welcome back, Congress! At noon EST on Friday, the 119^th Congress kicked off with a bang. While Congressman Mike Johnson won reelection to the role of Speaker, as was expected following the President-Elect’s public support last week, it was not without some drama when several conservative members of Congress initially voted against his reelection before they switched their votes. For our purposes, it highlights what is expected to be a recurring theme in the months ahead: the slim GOP majority will make it difficult for Congress to accomplish many items on the Administration’s agenda. Still, things are off to relatively smooth start for the Speaker. Elsewhere in the political world:

• • There was quite a fight over the Holiday season between different corners of the GOP world on an issue of importance to SNF’s: what is the proper role of the H1B visa and how strong should it be supported. The President-Elect eventually weighed in to support the visa.

• • With so many important items on the agenda, as well as a whole slew of cabinet positions that need Senate confirmation, a look at upcoming key dates. Hearings are expected to begin the week of January 13^th.

• • As the calendar turns to the new year, states are also beginning their legislative sessions. Here’s NCSL’s outlook on legislative topics that are being looked at in state capitals, as well as a calendar of all the different session dates.

• • With the Democratic party needing to do some deep introspection following their poor showing in the recent elections, a look at some of the rising stars in the party.

• • Several interesting CRS reports were issued over the last few weeks. The links are to the PDF:

• • R48139: A look at the development of AI in healthcare.
  • R48320: Might be of interest only to the lawyers, but a look at the Chevron decision and what it means for agency authority.
  • LSB10730: An updated guide to the Prep Act Covid protections.

AGENCIES:

CMS released a new QSO related to reporting requirements for LTC facilities and respiratory illnesses. It’s available here as a PDF.

HHS’ Office of Civil Rights released a notice of proposed rulemaking that would update the Cybersecurity requirements for healthcare providers related to HIPAA. They released a Fact Sheet breaking down the proposed rule. The notice was published to the Federal Register today. If you’re in the mood for some light reading, here’s a copy of the 125-page rule (PDF). Here’s a good summary of the rule.

The OIG at HHS released an analysis of SNF compliance with Medicare requirements for related party cost reporting. The summary is here (PDF) and the full report is here (PDF).

They also released a report analyzing payments to Critical Access Hospitals for services similar to SNF services, finding that the government could have saved money if they reimbursed at SNF levels. While not directly relevant to SNF’s, it’s another important data point highlighting the efficiency and cost-effectiveness of care provided by SNF’s. You can access the summary (PDF) and full report(PDF).

A good summary of the ongoing back & forth related to the filings required by the Corporate Transparency Act, which are currently back on hold.

FROM THE NOTEBOOK:

• • New York State got formal approval for a new tax on MCO’s that will be used to generate additional state Medicaid reimbursements.

• • A good look at the state of CON laws across the country and changes that have been made following the years of Covid.

• • A good read on the rising frustration with managed care and the rising usage of prior authorization requirements.

• • We’ve mentioned Mark Cuban’s Cost Plus Drugs endeavor a few times. The goal is to bring down drug prices. Yahoo did a deep dive into the model and the effects it can have.

ECAP Intel WhatsApp info:

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